Durrie Bouscaren

Fentanyl, a synthetic opioid painkiller, made up almost half of drug overdose deaths in parts of the St. Louis region last year, according to county coroners in Missouri and Illinois.

The drug is up to 50 times more powerful than heroin, and inhaling just a few grains can be lethal.

“If I can be blunt, it’s scary as hell,” said Brandon Costerison, a spokesperson for the anti-addiction group NCADA's St. Louis chapter. “And we don’t really have anything to indicate it’s subsiding yet.”

Missouri Attorney General Josh Hawley wants to get tough on human trafficking, which long has been a problem in the state. To do so, he proposed rules Monday that could make it easier to charge human traffickers with a crime.

The number of infants in Missouri who die in their first year is slowly dropping alongside national numbers, but St. Louis’ infant mortality rate has remained nearly stagnant, according to the Missouri Department of Health and Senior Services.

A new Missouri rule will strip state family planning funds from organizations that provide abortions, including hospitals. But several facilities are choosing to go without the money, instead of providing the state with a letter to certify that they do not offer the procedure.

At issue is a $10.8 million portion of the state’s Medicaid program, which covers pelvic exams, tests for sexually transmitted diseases and  family planning services for about 70,000 low-income Missouri women. To prevent violating a federal law that says Medicaid patients must be allowed to choose their own provider, the state is rejecting about $8.3 million annually in federal funds, and paying the difference with money from the state.

A Saint Louis University analysis of mosquito migration patterns and sexually transmitted diseases places the St. Louis region on a map of counties that could see an elevated risk for Zika infections this summer. The virus is spread by mosquitoes but can also be transmitted sexually for several months after symptoms occur.

However, the overall risk in the continental United States is still very low, study author Enbal Shacham said.

A central Illinois center for addiction treatment will stay open for now, despite payment delays during the state’s ongoing budget crisis. After two years without a permanent budget, the state is facing a backlog of $12.6 billion in unpaid bills to state employees, contractors and agencies.

Here’s something that may need to be clarified this tax season. Despite the ongoing debate in Washington over a repeal of the Affordable Care Act, the law’s requirement for people to be enrolled in health coverage or face a tax penalty is still on the books.

“People should go ahead and take care of their taxes as they would, as if the law hasn’t changed," said Geoff Oliver, a staff attorney for Legal Services of Eastern Missouri. "Because at this point the law hasn’t changed.”

Eastern Missouri has four full-time police officers dedicated to investigating human trafficking cases, but convictions are rare.

Law enforcement officials say it's hard to build cases against perpetrators because witnesses are few and victims often are unseen. To improve awareness, Webster University will hold a training session this weekend for law students and the general public. Attendees will hear how people are forced into sex work and other trades, and how to identify warning signs.

The name of a recently ousted Bel-Ridge police chief will appear on the ballot when the city’s voters elect new aldermen on April 4.

Gordon Brock led the Bel-Ridge Police Department for 16 years before his termination last winter, following accusations of harassment, mismanagement and accepting bribes.

States with rapidly aging populations, like Missouri, are seeing increased costs to Medicaid programs that cover low-income residents.

But the Republicans' health care proposal to replace the Affordable Care Act would create per-capita caps for federal Medicaid funding, potentially shifting increased costs to states. Advocacy groups for seniors warn that the proposal working its way through Congress may not adequately fund their care.

The Republican plan to replace major tenets of the Affordable Care Act would reduce the federal deficit by $337 billion over 10 years, according to new numbers from the nonpartisan Congressional Budget Office.

In that scenario, 24 million people would lose their health insurance, bringing the uninsured rate back up to nearly what it was before the Affordable Care Act. The White House has disputed these numbers.

After Congress extended the deadline for retired union coal workers and their families on the brink of losing their health insurance for four months, the group is again facing the loss of their coverage at the end of April.

In the meantime, a bill to use federal funds to maintain the benefits for about 22,000 former employees of now-bankrupt coal mines has not made it out of the Senate Finance Committee. Increasingly anxious retirees have written letters to their representatives, and are looking for other forms of coverage.  

If House Republicans pass their proposed replacement plan for the Affordable Care Act, state Medicaid programs would face some big changes, including a per-capita cap on spending.

Republicans introduced their plan Monday in the form of two budget reconciliation bills. Though the bills repeal several taxes that helped pay for the Affordable Care Act, they were sent into markup sessions before a cost estimate could be prepared by the Congressional Budget Office.

Members of Congress return to Washington on Monday after a week-long work sessions in their home districts.

Like some other around the country, St. Louis-area representatives are catching criticism for not using the break to host town hall meetings to hear from constituents.

There was one exception; Sen. Claire McCaskill, D-Mo., held a listening session Friday in Hillsboro regarding pension funds.

So where are your representatives, and why aren’t they holding public meetings? Here’s what they said.

Rep. Mike Bost, R-Murphysboro, Ill.